DOWNTOWN PEMBROKE SITE OF METHADONE CLINIC

Only Facility In Renfrew County To Serve People Fighting Opiate Addiction

The imminent opening of a methadone clinic in Pembroke is raising some
eyebrows -and some hackles -in the city.

The clinic is located at 140 Pembroke Street West, in the former
location of Pembroke Jewellers in the middle of downtown.

Officially it opens on Monday. The clinic is one of 25 in Ontario
operated by Ontario Addiction Treatment Centres (OATC).

Rhonda Daiter, director of operations for OATC, said there is a need
for a clinic in this area.

"Right now we have 20 patients from Renfrew County on the program
travelling to our clinics in Ottawa and Belleville," Ms. Daiter said.
"That's a pretty onerous trip week after week."

She could not estimate the eventual number of clients that will
utilize the program in Pembroke.

"It seems to be a bigger issue than what we're seeing now," she
said.

Methadone treatment programs are used as a means of treating opiate
addictions to substances like heroin, Percocet, Oxycontin, opium,
morphine, Dilaudid, codeine, Demerol, Fentanyl, and others.

"Our goal is harm reduction. We start clients taking baby steps. It's
about their goals, what they want. Some say they want to give up the
pain medication but they are not giving up marijuana. We don't force
anyone in the program. It's completely voluntary," Ms. Daiter said.

Over time, the clinic could expand into different areas.

Ms. Daiter said future plans have not been decided but if a group in
the community felt a needle exchange program was warranted, the clinic
could expand in that direction.

She expects the Pembroke clinic will draw clients from throughout
Renfrew County. She does not expect people from out of the area or
from big centres like Ottawa, as "people aren't going to go out of
their way to travel great distances." A client can just walk into the
clinic off the street, but there are requirements before being accepted into
the
program. First, there is the initial intake and a screening visit. The
client must also sign a contract and undergo a medical examination,
laboratory tests and urine screening for illicit drugs.

Ms. Daiter said a new client will take methadone daily but as they
progress through the program, the frequency of doses is reduced.

Methadone is taken orally, usually diluted in orange drink. According
to Ms. Daiter, nurses will oversee the methadone doses at the clinic.

Generally, a person stays in the program for at least one or two
years.

According to OATC, after two months of urine screens that are free of
illicit drugs, a client can earn take-home doses. The client is
responsible for the methadone, which could be lethal to a child or
non-opiate addicted person should they consume it. Diverting methadone
into the community is a criminal offence.

"We are tough on rules and policies," Ms. Daiter stated. "Clients sign
a six-page contract on behaviour and compliance."

Care at the centre is covered by OHIP, although clients have to pay
for the methadone.

Initially, the clinic in Pembroke will have a staff of three -two
nurses and a support worker. The nurses have been trained to help with
addiction counselling.

OATC has two executive directors, Dr. Jeff Daiter and Dr. Michael
Varenbut, but they are not often on site.

Ms. Daiter estimated that Dr. Daiter could be here about once a week
and added the clinic plans to utilize Telemedicine at the Pembroke
Regional Hospital to link physicians and clients if required.

Pierre Noel, hospital president and CEO, was away on Thursday, and
could not be reached to confirm if OATC had approached the hospital
about this.

Over time, Ms. Daiter expects that family physicians in the area may
assist at the clinic, as across the province, about 50 physicians are
part of the OATC team.

Pembroke Mayor Ed Jacyno said he was disappointed that OATC did not
notify the city about what it was doing. He found out about the clinic
when a downtown business owner called city hall asking if a methadone
clinic was moving in downtown.

According to Mayor Jacyno, a "clinic" is an acceptable use under the
planning act and as the building was purchased privately, city hall
was not notified about its intended use.

"Obviously a foot clinic or an eye clinic is a little different, so we
weren't too happy," Mayor Jacyno said. "Under the zoning parameters, a
clinic is a clinic."

He is sending a letter to the Minister of Health expressing his
concerns and stating there should be better communication when a
methadone clinic is moving into a community.

"We're not disputing the issue of people battling addictions. These
are people that are trying to better their life and alleviate a
serious problem, and that's fine. We have no argument with that. But
we should have been made aware," he said.

City council has asked that OATC speak to council about the clinic and
what it offers. A firm date for the meeting has not been set.

Shelley Burchart, chairwoman of the Pembroke Downtown Development
Commission, is also frustrated that OATC did not explain its
intentions to the downtown business community.

"Some members of the Pembroke Downtown Development Commission are
concerned that the opening of this clinic would mean a proliferation
of needles and other drug paraphernalia in the area," Ms. Burchart
said. "We are disappointed the operators of OATC did not approach the
PDDC during the planning phase for this clinic."

She added that she has since met with the staff of the clinic and will
be meeting with its director on Monday.

"The OATC staff provided information on their methadone maintenance
program and other clinic services which are operated under the
auspices of OHIP and the OMA. As I understand it, no needles are
utilized in the methadone treatment regimen and the client base is
comprised of individuals in the process of trying to improve the
overall quality of their lives," she said.

Several downtown business owners said they did not know a methadone
clinic was opening downtown and that they did not wish to comment at
this time.

Others were more outspoken.

Steve Goltz, owner of Brose Leather Goods, is among a group of
downtown business owners that feel the clinic should have located
elsewhere in the city.

"Why locate in a busy, downtown commercial area? This is not the place
for a methadone clinic. If it really is needed in Pembroke, then is
should be located away from the downtown area," Mr. Goltz said.

Michael Moncion of Michael Moncion Photography agrees with Mr.
Goltz.

"If it has to go somewhere, why in a retail, commercial environment? A
methadone clinic is not a retail or commercial business. Why not
locate in a hospital or medical environment -and that's not
downtown,"Mr. Moncion said.

He also feels there has been a lack of information provided to
surrounding businesses by the clinic and called their arival in the
city "secretive."

Ms. Daiter said clinics are usually located in the downtown areas of
communities.

"This has to do with transportation and where people are. They have to
come every day and transportation costs money. Most of our patients
are downtown where there is affordable housing," Ms. Daiter said. She
also said she didn't think OATC was being secretive about opening
aclinic in Pembroke. She said the city and businesses were not notified
because a clinic was an acceptable use for the building and therefore
there was no need for notification.

Rick MacDonald of Discount Computers is afraid that the methadone
clinic will attract drug-addicted people to the downtown and that the
clinic will expand into a needle or crack pipe exchange.

"My experience is that these things start small and then grow. Is that
the landscape that we want for downtown -a needle or crack pipe
exchange?" he asked.

According to Ms. Daiter, rules will be posted at the clinic, one of
which is no loitering. She said this includes outside the clinic but,
she added, the sidewalk is a public place and only so much control is
possible.

Ms. Daiter said she has statistics that show crime rates have dropped
in communities with clinics, as drug-addicted people turn away from
having to support their drug habit through illegal means like thievery
and the sex trade.